This cross-sectional study evaluated working conditions and the occurrence of self-reported musculo-skeletal symptoms among 251 Iranian sewing machine operators. A questionnaire and direct observa-tions of working postures using the rapid upper limb assessment (RULA) method were used. A high
prevalence of musculoskeletal symptoms, particularly in the neck/shoulders, back and hands/wrists were
found. The mean RULA grand score of 5.7 highlighted a poor sewing workstation design and indicated
that most operators (with posture assessed at action level 3) needed an investigation and changes in
their working habits soon. Work-related factors (including number of years worked as an operator,
prolonged working hours per shift, long duration of sitting work without a break, feeling pressure due to
work and working postures) and individual factors (including age, gender, BMI and regular sport/physical
activities) were associated with musculoskeletal symptoms in multiple logistic regression models. The
findings add to the understanding of working conditions of those jobs involving sewing activities and
emphasise the need for ergonomic interventions to reduce musculoskeletal symptoms in the future